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Miscellaneous dermatology

Dermatoses of pregnancy

Objectives

  • Recognise and manage common or important skin conditions arising in pregnancy.

Introduction

Pregnancy may result in an increase in prevalence or severity of some common skin problems. These include:

Palmar erythema of pregnancy

Pyogenic granuloma in pregnancy

Pustular psoriasis in pregnancy (impetigo herpetiformis)


Pregnancy makes management more difficult as many medications should be avoided. Refer to standard texts if you are prescribing for a pregnant or lactating female.

Acne management in pregnancy can include the topical agents benzoyl peroxide and azelaic acid, and oral erythromycin for severe cases. Salicylic acid, topical and oral retinoids and tetracyclines should be avoided. Topical steroids and tar preparations are permitted for inflammatory skin diseases; in some cases oral steroids may be necessary.

Prurigo of pregnancy

Itching is relatively prevalent in pregnancy. Causes include scabies, atopic eczema, contact dermatitis etc. In some cases, the itch is sometimes related to cholestasis and in others the cause is unknown.

Prurigo of pregnancy presents as scattered itchy/scratched papules at any stage of pregnancy. Often no primary lesion can be found. It should be managed with emollients, and topical steroids may help individual papules.

Prurigo of pregnancy

PUPPP

PUPPP is an acronym for Pruritic Urticated Papules and Plaques of Pregnancy, and is also known as polymorphous eruption of pregnancy. Features include:

PUPPP

Pemphigoid gestationis

Pemphigoid gestationis is a rare blistering disease due to circulating autoantibodies similar to bullous pemphigoid. Features include:

pemphigoid gestationis